45 Minutes of Patient Education Boosts Chronic Disease Management

November 27, 2018 - A health literacy program that required second-year medical students to spend an additional 45 minutes delivering patient education helped improve chronic disease management and health outcomes, a study published in the Journal of the American Osteopathic Association.

While healthcare providers play a key role in helping patients manage their chronic conditions, patients must also take an active part in maintaining their health status.

However, the researchers pointed out that it can be difficult for patients to succeed with chronic disease self-management, especially for those living in rural or underserved areas where access to care may be limited.

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Developing medical students’ communication skills can help future physicians improve self-management for patients, but this training is typically not included in medical school curricula.

To improve chronic disease self-management among underserved patients, and to improve educational skills among medical students, researchers at the Edward Via College of Osteopathic Medicine developed an education curriculum called The Other 45.

Typically, a physician is given 15 minutes to speak with a patient, conduct a physical exam, offer a diagnosis, and prescribe medication. This tight schedule often doesn’t leave time for providers to ensure their patients have a thorough understanding of their condition and how to manage it.

The Other 45 program allows patients with a chronic condition to meet with a second-year medical student for an additional 45 minutes to discuss their diagnosis, prescriptions, and preventive measures.

Forty-seven chronic disease patients participated in three visits for The Other 45 and completed the Health Education Impact Questionnaire after each session. Researchers found that these patients showed significant improvements in constructive attitudes and approaches and health services navigation. At the 3-month follow-up visit, patients also showed improved self-monitoring and insight, positive and active engagement in life, and emotional well-being.

Students also completed a pre- and post-clinic survey measuring their delivery patient-centered care, clinical confidence, and medical knowledge. The results showed that all 69 participating students demonstrated improvements in the three domains after completing the program.

“The self-reported results of this study indicate that participating in The Other 45 significantly improves patients’ ability to self-manage their chronic disease(s) and also enhances medical students’ perceptions of their patient-centered care, clinical confidence, and medical/teaching knowledge,” the researchers said.

The program also allowed students to take a holistic approach to care and address the non-clinical factors that may influence underserved patients’ health and wellbeing.

These findings echo a recent report from the National Quality Forum, which said that to improve rural patients’ health literacy, both patients and providers must understand the important role patients play in their own care. Organizations should also work to improve patient-provider communication overall to improve rural access to care and health outcomes.

The Edward Via College group noted that the study had some limitations. Transportation and scheduling conflicts resulted in a lower patient sample size, and researchers believe future studies should examine longer-term health outcomes that result from The Other 45 and other health literacy programs.

“As chronic disease rates will continue to rise and be the leading cause of death across the United States, it is imperative that patients are provided adequate support for self-management. As indicated in the literature and within this study, education has the potential to help patients improve across many constructs that affect their ability to best manage their diseases,” the researchers concluded.

“Helping future physicians develop the tools to provide their patients knowledge and skills regarding their chronic disease is one method to help deliver this education.”